Observation Stays No Longer Subject to Concurrent Review

FirstCare Health Plans will update its authorization requirements for 2015. Below is a summary of upcoming changes to our Prior Authorization Matrix:

Medical Pharmacy Update

An updated medical pharmacy list can be found here, and it includes all medications that currently require prior authorization, as well as new additions which will go into effect as of February 1, 2015.

Note: This list applies to medications covered under FirstCare’s medical benefit. For medications obtained through the FirstCare pharmacy benefit, please refer to the appropriate drug list for the members plans: HMO/PPO, Medicaid, Medicare.

Prior Authorization Matrix Changes

Effective December 1, 2014, some authorization requirements have been removed from our Prior Authorization Matrix, including: